Values, Policies and Rights

US project planning to sterilise HIV+ women in South Africa
Thom A: Health-e News, 11 April 2011

A controversial United States-based project that pays drug users and alcoholics to undergo sterilisation or long-term contraception, is alleged in this article to be setting its sights on women living with HIV in South Africa. The Founder of Project Prevention is reported to have confirmed that they were making plans to offer similar services to women living with HIV in South Africa as well as drug users, in co-operation with local non-governmental organisations. However a government official in the Maternal, Child and Women’s Health in the Department of Health is reported to have said they would approach the Human Rights Commission if the project started operating in South Africa, and that doctors found involved in such medical interventions could be reported to the Health Professions Council of South Africa.

Using human rights for sexual and reproductive health: Improving legal and regulatory frameworks
Cottingham J, Kismodi E, Hilber AM, Lincetto O, Stahlhofer M and Gruskin S: Bulletin of the World Health Organization 88:551–555, July 2010

This paper describes the development of a tool that uses human rights concepts and methods to improve relevant laws, regulations and policies related to sexual and reproductive health. This tool aims to improve awareness and understanding of States’ human rights obligations. It includes a method for systematically examining the status of vulnerable groups, involving non-health sectors, fostering a genuine process of civil society participation and developing recommendations to address regulatory and policy barriers to sexual and reproductive health with a clear assignment of responsibility. Strong leadership from the ministry of health, with support from the World Health Organization or other international partners, and the serious engagement of all involved in this process can strengthen the links between human rights and sexual and reproductive health, and contribute to national achievement of the highest attainable standard of health.

Using Human Rights to Combat the HIV/AIDS Pandemic

The HIV/AIDS pandemic presents a stark example of the nexus between human rights and health. This first became evident when government responses to HIV/AIDS subjected people living with the disease to violations of their rights to liberty, privacy, freedom of association, nondiscrimination, and equality before the law. As the pandemic has progressed, it has become apparent that human rights law is relevant not only to the treatment of infected individuals but also to wider policies that influence vulnerability to HIV/AIDS, as populations that are discriminated against, marginalized, and stigmatized are at a greater risk of contracting the disease.

Using human rights to improve maternal and neonatal health: History, connections and a proposed practical approach
Gruskin S, Cottingham J, Hilber AM, Kismodi E, Lincetto O and Roseman MJ: WHO Bulletin 86 (8), 2008

This paper describes how maternal and neonatal mortality in the developing world came to be seen as a public-health concern, a human rights concern, and ultimately as both, leading to the development of approaches using human rights concepts and methods to advance maternal and neonatal health. It describes the different contributions of the international community, women's health advocates and human rights activists.

Using the constitution for social justice in Africa

Zackie Achmat, the leader of the Treatment Action Campaign (TAC), spoke at the Centre for Civil Society's first Harold Wolpe Memorial lecture for 2004. Achmat is famous for his passionate advocacy for wider access to HIV treatment in South Africa and globally. Strategic use of South Africa's Constitutional provision for the right to access to health care has always been key to TAC's campaigns. As South Africa moves towards celebrating ten years of a constitutional democracy, it was apt that such a high-profile civil society leader discussed the use of the constitution as a tactic to engage with the government on development issues. In this review, the authors summarise Achmat's talk, the interesting critiques from the floor and offer their own critical analysis of the lecture and discussion which followed it.

Using the Right to Health to Enforce the Corporate Responsibilities of Pharmaceutical Companies with Regard to Access to Medicines
Oke E: Journal of Health Diplomacy (1) 1: July 2013

This paper seeks to determine how the corporate responsibilities of pharmaceutical companies in relation to access to medicines can be clarified and enforced. Two cases, one each from India and South Africa, are examined to determine how the domestic courts in both countries indirectly utilized the right to health to ensure that pharmaceutical companies did not impede access to affordable medicines through exercising their patent rights. There is a need to clarify and enforce the responsibilities pharmaceutical companies have to promote the right to health. The two cases from India and South Africa demonstrate the potentials of domestic courts as forums where these responsibilities can be effectively enforced. In the absence of a global enforcement mechanism for enforcing the right-to-health responsibilities of pharmaceutical companies, domestic courts can effectively fill this gap. In addition, this paper demonstrates that domestic courts can equally serve as forums for health diplomacy.

Vienna Declaration calls for science-based drug policies
AIDS Map: 30 June 2010

Three leading scientific and health policy organisations have launched a global drive for signatories to the Vienna Declaration, a statement seeking to improve community health and safety by calling for the incorporation of scientific evidence into illicit drug policies. Misguided drug policies that criminalise drug abuse are claimed to fuel the AIDS epidemic and result in violence, increased crime rates and destabilisation of entire states, without evidence they have reduced rates of drug use or drug supply. Scientists are calling for evidence-based approaches to illicit drug policy that start by recognising that addiction is a medical condition, not a crime. The Vienna Declaration describes the known harms of conventional ‘war on drugs’ approaches and calls for governments to implement evidence-based approaches that respect, protect and fulfil human rights, as well as reduce harms deriving from current policies. This would allow for the redirection of the vast financial resources towards where they are needed most: implementing and evaluating evidence-based prevention, regulatory, treatment and harm reduction interventions. Legal barriers to scientifically proven prevention services such as needle programmes and opioid substitution therapy (OST) mean hundreds of thousands of people become infected with HIV and Hepatitis C (HCV) every year.

Violence against women and girls in the Horn of Africa: The untold story
Costa S and the Women’s Refugee Commission: Huffington Post, 31 August 2011

This article reports that Somali women and girls living in Ethiopian and Kenyan refugee camps are facing major health problems as camps lack security and basic services like latrines, accompanied by a fourfold increase in reports of sexual violence since May 2011. The real numbers are likely much higher, the Women’s Refugee Commission (WRC) notes, because many women and girls fail to report attacks for fear of their safety, because they don't want to be ostracised or because they don't trust that their rapists will ever be caught or prosecuted. Some of those living in the camps also face violence from their partners, and some are being forced into early marriage or survival sex, because they have no other way to support themselves. WRC argues that immediate action will more effectively protect women and girls than trying to fix problems after they have become entrenched. WRC recommendations include not only ensuring that women and girls have safe access to basic necessities, such as food, cooking fuel, potable water, sanitation and shelter, but that they are protected from sexual violence and that health care, particularly reproductive health care, is provided, using the updated Minimum Initial Service Package for reproductive health as a basis. WRC calls on the international community to rapidly scale up efforts initiated by humanitarian agencies in the region.

WHA defers to 2014 decision on smallpox virus stocks destruction
Li Ching L, SUNS #7158 26 May 2011

Attempts by the United States to prolong the retention of variola (smallpox) virus stocks have been thwarted at the World Health Assembly (WHA) that met from 16 to 24 May. The WHA instead decided to put aside the US proposal in favour of resuming the discussion at the 67th WHA in 2014. The decision followed contentious discussions on a draft resolution, proposed by the US and several co-sponsors, that would have allowed continued retention of the existing virus stocks, with a report on progress of research only in five years' time (2017), at the 69th WHA. Despite an informal working group meeting to deliberate the issue, there was no consensus and a decision was then made to defer the discussion on the draft resolution. In the final decision adopted on 24 May, the WHA decided to strongly reaffirm the decisions of previous WHA sessions that the remaining stocks of variola virus should be destroyed. It also reaffirmed the need to reach consensus on a proposed new date for the destruction of variola virus stocks when research outcomes critical to an improved public health response to an outbreak so permit. It further decided to include a substantive item "Smallpox eradication: Destruction of variola virus stocks" on the provisional agenda of the 67th WHA session.

What can be done to accelerate progress against undernutrition?
id21HealthNews 73, July 2008

Many organisations work to eliminate undernutrition in children and pregnant and lactating women in developing countries. These organisations - international organisations, donors, academia, civil society and private sector - are loosely linked as an international nutrition system. However, this system is fragmented and dysfunctional. Individual organisations and the system as a whole must examine their strategies, resources and motivations. Organisations must significantly improve their links with national level processes, so that country level priorities are better reflected in international guidance, donor funding, research and training.

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